成人急性髓细胞白血病P-糖蛋白表达特点及其预后意义

Expression of P glycoprotein in Adult Acute Myeloid Leukemia and Its Clinical Significance

用抗多药耐药Ｐ－糖蛋白（Ｐ－ｇｐ）及流式细胞仪间接免疫荧光法检测了１７３例初治、２３例难治成人急性髓细胞白血病（ＡＭＬ）细胞Ｐ－ｇｐ的表达。结果发现，Ｐ－ｇｐ阳性率在初治者及难治者分别为２９．５％及６５．２％，二者比较具有显著性差异（Ｐ＜０．００１）；难治者以Ｐ－ｇｐ高表达为主。不同ＡＭＬ亚型、不同患者Ｐ－ｇｐ表达差异显著，以杂合性白血病表达最高（７５％），Ｍ３表达最低（３．６％）。Ｐ－ｇｐ＋患者的完全缓解（ＣＲ）率为１６．９％，显著低于Ｐ－ｇｐ－者的７６．５％（Ｐ＜０．００１）。Ｐ－ｇｐ＋Ｍ１、Ｍ２、Ｍ５患者的ＣＲ率分别显著低于相应的Ｐ－ｇｐ－者（Ｐ值分别为＜０．００５，＜０．００１及＜０．０５）。

P glycoprotein (Pgp) expression was determined in 173 patients with acute myeloid leukemia and 23 refractory cases using monoclonal antibody UIC2 and flow cytometry indirect immunofluorescence technique. The results showed that Pgp was expressed in 29.5% of previously untreated AML which was less than 65.2% of refractory cases ( P < 0.001) . Pgp expression varied with different AML subsets and different cases. Pgp expression was highest in hybrid acute leukemia (75%) and lowest in M3 (3.6%). The complete remission (CR) rate of Pgp positive cases 16.9% which was significantly lower than 76.5% of Pgp negative cases ( P <0.001). For patients with M1, M2 and M5 Pgp positive cases the CR rates were relatively lower than their counterparts with Pgp negative ( P <0.005, P < 0.001) and P <0.05 respectively). Therefore, the Pgp expression is suggested as an index of poor prognosis in adult AML.